Members of the Board are asked whether they
have any personal or prejudicial interests in connection with any
application on the agenda and, if so, to declare them and state the
nature of the interest.

Minutes:

Councillor C Jones declared a personal
interest by virtue of her employment with the Cheshire and Wirral
Partnership NHS Foundation Trust.

Councillor Phil
Gilchrist declared a personal interest in general by virtue of
being Cheshire and Wirral NHS Partnership Trust Appointed
Governor.

To approve the accuracy of the Minutes of the
meeting of the Health and Wellbeing Formal Board held on 12
November, 2014.

Minutes:

Resolved –
That subject to the removal of the comment attributed to Dr Pete
Naylor in the second paragraph of Minute 66 Update on response to
Better Care Fund that the accuracy of the Minutes of the Health and
Wellbeing Formal Board held on 12 November, 2014 be approved as a
correct record.

The Board considered a report of the Director
of Public Health that outlined
Wirral Health and Wellbeing Boards participation in a Peer
Challenge process during 26-29 January, 2015. The Peer Challenge was the Local Government
Association’s health and wellbeing system improvement
programme, co-created with a number of national organisations (e.g.
Department of Health, NHS Confederation, Public Health
England).

During the four days of the visit the Peer
Challenge team had run 42 sessions and met with 84 people to
support their understanding of five headline questions. The membership of the Peer Challenge team, and the
key questions were provided in Appendix 1 of the report. While
feedback had been given through a presentation shortly after the
visit, Wirral Health and Wellbeing Board had received the letter
from the Peer Challenge team included in Appendix 1 of the report,
which detailed the main findings from the review and the key
recommendations. The Board was now
required to receive this letter and consider its next steps in
response to the recommendations made.

The report noted that the Wirral Health and
Wellbeing Board had identified the need for a clear vision, with a
narrative for Wirral, together with effective programme management
and communication with wider stakeholders as crucially
important. The Peer Challengers had
recommended that the partnership structure on Wirral be reviewed
and the place of the Wirral Health and Wellbeing Board be clarified
along with other partnerships and working groups that existed.

The report also noted a significant component
of the peer review feedback focussed on the need for a clear
narrative and strategic direction for the Board. It was reported
that a piece of work had recently been undertaken to identify the
key themes within the vision statements of key partner
organisations. From this work, a number of draft strategic aims
were listed in the report which could accompany the overarching
vision statement.

Fiona Johnstone, Director of Public Health,
commented that the Board was being asked to reflect on the Peer
Review feedback. There was a general view that Board members were
concerned that the Board did not have measurable outcomes.
Councillor Phil Davies suggested that a smaller group could look at
the broad strategic aims for the Board and report back to a Health
and Wellbeing Board Development Session. Fiona Johnstone stated that this would be welcomed
and asked for the nomination of a representative from each
partnership for this group to be set up. It was agreed that this group could take another
look at Wirral’s Joint Strategic Needs Assessment, how the
Board could carry out effective communication and engagement and
give consideration to examples from other Health and Wellbeing
Boards for reference. Its recommendations would be brought back to
the Health and Wellbeing Board Development Session.

Members gave consideration to a report of
Wirral Partners that informed the Board that Wirral had recently
been successful in bidding to be a Vanguard site for the national
Five Year Forward View programme developed by NHS
England. The intention of the programme
was to test the models of care described in the NHSE December
planning guidance - The Forward View into Action.

It was reported that initially, NHSE had
invited interest in four models:

•multi-specialty community providers
(MCPs);

•
integrated primary and acute care systems (PACS);

•additional approaches to creating
smaller viable hospitals; and

•models of enhanced health in care
homes.

It was reported that the Wirral bid had been
submitted in partnership with three other organisations: Cerner UK
Ltd (cornerstone partner in the delivery of informatics solutions
and promotion population health management), Advocate Physician
Partners ACO, (USA)(cornerstone partner
in the delivery of modelled Accountable Care Organisation
deployment and learning) and the King’s Fund (cornerstone
partner in the delivery of research, learning, evaluation and
dissemination). A copy of the submitted
application was attached to this report.

Wirral Health and Wellbeing Board partners
were committed to developing a Vision for future health and social
care services on Wirral since 2014. A
significant amount of activity had been taking place to develop
programmes and work-streams that would deliver positive services
for our local population, while at the same time promoting
prevention, and enabling effective demand management. The Vanguard programme provided an opportunity to
integrate the ideas outlined in the Five Year Forward View with the
existing approaches being developed through Vision
2018. The bid that was submitted was
attached as Appendix 1 to the report.

Anthony Hassall Executive Director of
Strategic & Organisational Development attended the meeting and
gave members a presentation on ‘New Models of Care for the
Wirral’.

Resolved –
That;

1.thesuccessful outcome of Wirral’s application to be a
Vanguard site for the Five Year Forward View be noted.

2.theHealth
and Wellbeing Board receive regular feedback on progress with this
initiative.

A report of the Director of Adult Social
Services provided an overview of the latest position of the Better
Care Fund (BCF). The BCF had been signed off with assurance from
NHS England in September 2014. The BCF represented partnership
working between the Clinical Commissioning Group (CCG), Local
Authority and key providers.

Jacqui Evans, Head of Transformation, Adult
Social Services attended the meeting to provide an overview of the
report and responded to Members questions.

It was reported that there has been a recent
review of the original schemes to ensure that they remained aligned
with Vision 2018, the CCG 5-year plan and in line with the
considerable financial challenges the Health and Social Care
economy faced.

The economy would be performance measured
against its ability to reduce emergency admissions through BCF
investment. This figure was originally
set at a reduction of 5%, against 2014/15 baseline by 31 March
2016. However, in light of A&E
performance over the winter period and the challenging admissions
trajectory, Wirral had revised its position to a target of
3.5%. This remained a significant
challenge, equal to a reduction of approximately 6 admissions a
day.

It was also reported that there was a national
requirement for the BCF to be managed via a pooled budget by April
2015. Resources would be pooled through
a Section 75 agreement, which set out governance arrangements
including how risks such as under performance or overspend against
individual schemes would be managed. It
had been agreed that the pooled budget would be hosted by the local
Authority. The CCG Director of Finance
had jointly written the Section 75 request. The Director of Adult Social Services and the CCG
Director of Finance would directly oversee the governance of the
pooled budget.

Members raised concern about the areas of the
Specialist Alcohol Unit and the Alcohol Triage Service
savings. Superintendent John Martin
highlighted the serious impact on services due to the abuse of
alcohol and questioned what would be in place. Jacqui Evans gave an explanation of alcohol
services and Members expressed the view that there needed to be
further consideration as to how appropriate care would meet
needs.

Members gave consideration to a report
prepared by Andrew Crawshaw, NHS.
England. Richard Freeman, NHS England attended the meeting and
provided an overview of the report. NHS England provided a
quarterly Accountability report to each Health and Wellbeing
Board. The report outlined the national
and regional context together with specific update on priorities
that the Area Teams were responsible for delivering and how these
priorities were progressing.

Members were provided with an update on NHS
England and informed of the progress on the Two Year Operational
Plans as well as the development of the Cheshire and Merseyside
Business Plan for 2015/16.

The report included details of New Care Models
– Vanguard sites – Minute 80 refers. NHS England had
announced the first 29 ‘vanguard’ sites that would
transform care for five million patients across
England. The sites, supported by the
New Care Models Programme, had been chosen from 269 applications to
trail blaze new ways of providing more joined-up, personal care for
patients and increase efficiency.

Groups of nurses, doctors and other health
staff from across the country had put
forward their ideas for how they want to redesign care in their
areas, and now the NHS would be backing 29 of the most innovative
plans, with the aim of bringing home care, community nursing, GP
services and hospitals together for the first time since 1948.

Drawing on bespoke packages of national
support and a £200 million transformation fund, from April
the vanguards would develop local health and care services to keep
people well, reduce demand and improve productivity.

The vanguards would take the national lead on
the development of game-changing care models:

•multispecialty community providers
(MCPs) – moving specialist care out of hospitals into the
community;

•
models of enhanced health in care homes – offering older
people better, joined up health, care and rehabilitation
services.

For patients, this could mean fewer trips to
hospitals as cancer and dementia specialists hold clinics local
surgeries, one point of call for family doctors, community nurses,
social and mental health services, or access to blood tests,
dialysis or even chemotherapy closer to home.

Locally there were the following vanguard
sites: Wirral University Teaching Hospital NHS Foundation Trust and
Primary Care Cheshire. Further
information was available on the following link:-

Paul Wormald, Commissioning Support Manager
(Partnerships), Norma Currie, Commissioning Manager (Partnerships)
and Annamarie Jones, Commissioning Lead, Department of Adult Social
Services attended the meeting and provided the Board with a
presentation on Learning Disabilities Self-Assessment Framework Assessment. The Joint
Health and Social Care Learning Disabilities Self-Assessment
Framework helped to provide a single, consistent way of identifying
the challenges and caring for the needs of people with learning
disabilities and documenting the extent to which the shared goals
of providing care are met. The presentation outlined the type of
information collected, Comparision
between 2012-2013 and 2013-2014 (Rag Rated), the key successes in
the last 12 months, examples of good practice and an Action Plan
for 2015 - 2016.

A report of the Director of Public Health
informed the Board that the formal consultation for Wirral’s
new Pharmaceutical Needs Assessment (PNA) was now complete. To meet
the deadline for publication of the 1st April 2015 the Chair had
approved the document in March, the Board was therefore asked to
ratify the Chair’s action.

Resolved –
That the decision to approve the Wirral’s Pharmaceutical
Needs (PNA) by the Chair of the Health and Wellbeing Board be
ratified.

85.

DATE OF NEXT FORMAL BOARD MEETING

The date of the next formal Board meeting is
Wednesday 8 July, 2015 at 4:00pm in Committee Room 1, Town Hall,
Wallasey.

Minutes:

The date of the next Formal Board was to be
held on Wednesday, 8 July, 2015.